International Journal of Chronic Obstructive Pulmonary Disease最新文献

{"title":"Recommendations for Improving Discharge-Related Care Following a COPD Exacerbation: An Expert Panel Consensus with Emphasis on Low- and Middle-Income Countries.","authors":"Adrian Rendon, Susana Luhning, Philip Bardin, Carlos Andrés Celis-Preciado, Moustafa El Shazly, Mark Cohen-Todd, Ahmad Izuanuddin Ismail, Majdy Idrees, Seong Yong Lim, Pin-Kuei Fu, Terence Seemungal, Nurdan Köktürk, John R Hurst","doi":"10.2147/COPD.S502971","DOIUrl":"https://doi.org/10.2147/COPD.S502971","url":null,"abstract":"<p><p>Exacerbations of chronic obstructive pulmonary disease (COPD) continue to place a considerable disease and financial burden on both patients and healthcare systems, particularly in low- and middle-income countries (LMICs). Therefore, preventing future exacerbations remains a key treatment goal. However, gaps remain in the standard of COPD care following exacerbations, despite the availability of evidence-based recommendations providing guidance on discharging patients from hospital or emergency department (ED) after a COPD exacerbation. To better understand these gaps in clinical practice, an advisory board meeting of 13 international pulmonologists was convened in September 2022, with the principal objective to formulate and recommend an evidence-based hospital discharge protocol following a COPD exacerbation, with a particular focus on LMICs. Based on identified gaps in COPD care, recommendations for alleviating the burden of exacerbations were proposed, which could be delivered as a discharge protocol for implementation in hospitals and/or ED. Following a review of the available clinical evidence, including an online survey of 11 pre-meeting questions and 5 additional questions discussed during the meeting, the key unmet needs identified by the experts included poor integration of standardized protocols in routine clinical practice, failure to ensure consistent delivery of post-discharge care, and lack of efficiently functioning healthcare systems. A protocol was formulated for delivery as part of a disease management program involving an interdisciplinary approach and a care bundle, aiming to address gaps in discharge-related care by determining the likelihood of readmission and optimizing maintenance treatment plans based on assessment of symptoms and future exacerbation risk. This can provide holistic care following hospital/ED discharge and personalized treatment plans by advocating referral to a specialist. To ensure wide-ranging uptake, implementation of a discharge protocol will need to be tailored to local healthcare settings by conducting feasibility studies, standardizing clinical pathways and healthcare policies, and engaging relevant stakeholders.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1111-1129"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Cuproptosis-Related Genes and Their Potential Role in COPD Pathogenesis: A Bioinformatics Analysis.","authors":"Qin Shen, Jin-Bo Huang, Mi Zhu, Dao-Jun Ji, Si-Jia Huang, Jun Li","doi":"10.2147/COPD.S497473","DOIUrl":"https://doi.org/10.2147/COPD.S497473","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide, and its pathogenesis and potentially relevant biomarkers require further study. Imbalance in copper (Cu²⁺) metabolism is related to a series of diseases, but its role in COPD has not been specified.</p><p><strong>Methods: </strong>A dataset relevant to COPD was downloaded from Gene Expression Omnibus database, among which a total of 18 cuproptosis-related genes (CRGs) were screened. The SimDesign package was used to perform single-factor Rogers regression to screen genes associated with disease phenotypes, risk score prediction models were constructed, and Receiver Operating Characteristic (ROC) curves were used to evaluate the efficacy of the prediction models. In addition, we verified the expression of CRGs in subtypes and the correlation between subtypes and clinical characteristics using a database. Finally, immune correlation analysis was used to explore immune cell infiltration.</p><p><strong>Results: </strong>Five biomarkers (DLST, GLS, LIPT1, MTF1, and PDHB) were identified. ROC analysis illustrated that these five biomarkers performed well (area under the curve (AUCs)>0.7), and the enrichment scores of diagnostic CRGs were significantly different among subtypes, among which the chi-square test P-values of the age groups were significantly different. The immune infiltration evaluation of cuproptosis subtypes revealed that the correlation analysis results of 22 types of immune cells showed a significant correlation between these cells, and the five CRGs were significantly correlated with the content of most immune cells in the 22 types of immune cells. The four pathways with the most significant differences in GSEA among subtypes were Oxidative Phosphorylation, Parkinson's Disease, Purine Metabolism, and Drug Metabolism Cytochrome P450.</p><p><strong>Conclusion: </strong>This study identified five candidate genes for further investigation (DLST, GLS, LIPT1, MTF1, and PDHB) and constructed disease prediction models and pathogenesis pathways. This study can provide a basis for further research on the role of cuproptosis in COPD.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1083-1096"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise Prescription Training in Chronic Obstructive Pulmonary Disease: Benefits and Mechanisms.","authors":"Siqi Liu, Ailin Yang, Yue Yu, Bo Xu, Ganggang Yu, Haoyan Wang","doi":"10.2147/COPD.S512275","DOIUrl":"https://doi.org/10.2147/COPD.S512275","url":null,"abstract":"<p><p>Exercise rehabilitation training has emerged as one of the most promising modalities for enhancing clinical outcomes and overall well-being in patients with chronic obstructive pulmonary disease (COPD). Distinct exercise prescriptions yield different clinical benefits in this population. Endurance training has been demonstrated to significantly improve exercise capacity, alleviate dyspnea, and enhance health-related quality of life metrics. High-intensity interval training offers a time-efficient approach to boosting cardiorespiratory fitness and metabolic function. Resistance training addresses progressive muscle atrophy through targeted myofiber recruitment, thereby augmenting musculoskeletal performance and translating to enhanced exercise tolerance in patients with COPD. Exercise-mediated rehabilitation attenuates COPD progression and mitigates acute exacerbation risks via multifactorial mechanisms such as mitigation of inflammatory responses, reduction of oxidative stress, and improvement of endothelial cell function. Elucidating the pathophysiological mechanisms underlying exercise-induced benefits will pave the way for precision rehabilitation protocols, ultimately advancing COPD disease management paradigms, refining patient-centered outcome measures, and achieving sustainable health optimization in this clinical cohort.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1071-1082"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Outcomes of Eosinophilic Exacerbations of COPD.","authors":"Matthew Donnan, Tong Lei Liu, Matthew Gvalda, Xinye Chen, Chuan T Foo, Martin Ian MacDonald, Francis Thien","doi":"10.2147/COPD.S485246","DOIUrl":"https://doi.org/10.2147/COPD.S485246","url":null,"abstract":"<p><strong>Introduction: </strong>The role of eosinophilic inflammation in exacerbations of chronic obstructive pulmonary disease (COPD) is increasingly recognised. Eosinophilic exacerbations have previously been associated with shorter hospital length of stay and lower inpatient mortality. The objective of this study was to examine clinical characteristics of hospitalised COPD exacerbations stratified by admission eosinophil count.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of exacerbations of COPD at an Australian tertiary health service between 1^st October 2019 and 30^th September 2020 that were identified using ICD-10 discharge codes. Patients were excluded if they received any systemic corticosteroids prior to hospitalisation. Admissions were stratified according to blood eosinophil count as high eosinophil (HE, ≥2% total white blood cell count), or low eosinophil (LE, <2%).</p><p><strong>Results: </strong>Four hundred and six patients were analysed. HE patients were younger (74.7 vs 77.7 years, p=0.001) and had fewer co-morbidities (1 [1-2] vs 2 [1-3], p=0.044). Patients with HE were less likely to be taking inhaled corticosteroids (59% vs 71%, p=0.017). HE exacerbations had a higher blood eosinophil count (0.31 vs 0.06 × 10⁹/L, p<0.0001), lower total white cell count (8.45 vs 10.6, p<0.001), lower CRP (10.4 vs 26.7, p<0.001), fewer infections (29.5% vs 52.1%, p<0.001) and less oxygen requirement (35.2% vs 46.8%, p=0.036). HE exacerbations had a shorter length of stay (3.56 vs 4.40 days, p=0.047) but similar inpatient mortality.</p><p><strong>Discussion: </strong>Eosinophilic exacerbations of COPD were phenotypically different, affect a younger, less co-morbid population and were associated with shorter length of stay. This may be useful to help prognosticate clinical outcomes and guide clinical management.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1061-1070"},"PeriodicalIF":2.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on ACO Prevalence Among AECOPD Patients (2019-2023) and Clinical Characteristics by Blood Eosinophil Levels.","authors":"Siming Zhang, Wenhui Song, Tongxinwei Sun, Siyu Wu, Zheng Wang, Aihong Meng","doi":"10.2147/COPD.S501626","DOIUrl":"https://doi.org/10.2147/COPD.S501626","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate changes in the prevalence of Asthma-COPD Overlap (ACO) among patients with Acute Exacerbations of COPD (AECOPD) from 2019 to 2023. It also compared the clinical characteristics of patients across EOS thresholds (50, 150, and 300 cells/μL) to identify disease severity markers and guide individualized treatment strategies.</p><p><strong>Patients and methods: </strong>Clinical data from AECOPD and ACO patients hospitalized at the Second Hospital of Hebei Medical University between January 2019 and December 2023 were analyzed. Patients were grouped by EOS levels (50, 150, and 300 cells/μL), and their clinical characteristics were compared.</p><p><strong>Results: </strong>Among 408 AECOPD and 275 ACO patients, the prevalence of ACO during the late pandemic period in 2023 was significantly higher than in the pre-pandemic period in 2019. ACO patients during the late pandemic period showed increased EOS counts and FeNO levels compared to pre-pandemic patients (P < 0.05). In AECOPD patients, those with EOS <50 cells/μL had lower lymphocyte counts and higher NLR and FDP levels than other groups. Similarly, in ACO patients, the EOS <50 cells/μL group showed lower lymphocyte counts and higher NLR levels. Patients with EOS ≥300 cells/μL were younger and exhibited higher FeNO levels than the EOS <50 and 50-150 cells/μL groups (P <0.05).</p><p><strong>Conclusion: </strong>The prevalence of ACO among AECOPD patients increased during the late pandemic period, possibly indicating a role for type 2 inflammation. EOS thresholds of 50, 150, and 300 cells/μL may serve as markers of disease severity and aid in tailoring individualized treatment strategies.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1051-1060"},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness of Single-Inhaler Triple Treatment Through Assorted Respiratory Outcomes When Switched From Multiple-Inhaler Triple Therapies (RESTART): A Prospective Cohort Study of Korean Patients With COPD.","authors":"Hana Lim, Dong Han Kim, Song Hee Hong, Juyoung Shin, Hyesung Lee, Kyeongcheol Shin, Seung Won Ra, Seung Jun Lee","doi":"10.2147/COPD.S499686","DOIUrl":"https://doi.org/10.2147/COPD.S499686","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition characterized by persistent airflow limitation, leading to significant morbidity and mortality. Despite the effectiveness of multiple inhaler triple therapy (MITT), its complexity often results in poor adherence and suboptimal outcomes. Transitioning to single inhaler triple therapy (SITT) may enhance adherence, leading to improved clinical outcomes and quality of life of patients. The Real-World Effectiveness of Single Inhaler Triple Treatment through Assorted Respiratory Outcomes when Switched from Multiple Inhaler Triple Therapies (RESTART) study aimed to evaluate the clinical benefits of switching from MITT to SITT using fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) in a real-world Korean setting.</p><p><strong>Patients and methods: </strong>This prospective, multicenter, observational study enrolled 107 patients, aged 40 and older, with diagnosed COPD, all previously on MITT. The patients were transitioned to once-daily FF/UMEC/VI administered via the ELLIPTA inhaler. The primary outcome was a change in the COPD Assessment Test (CAT) score after 24 weeks. The secondary outcomes included changes in lung function, exacerbation rates, Modified Medical Research Council Dyspnea Scale scores, and Treatment Satisfaction-Visual Analysis Scale (TS-VAS) scores.</p><p><strong>Results: </strong>A total of 91 patients completed the 24-week observation. CAT scores significantly improved (mean change = 1.40 points, <i>P</i> = 0.007). Lung function also improved, with a mean increase in the FEV1/FVC ratio (mean change = 4.31%, <i>P</i> = 0.005). Exacerbation rates decreased significantly (incidence rate ratio = 0.45, <i>P</i> = 0.016). Treatment satisfaction increased, with a mean TS-VAS score rise of 1.71 points (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The transition from MITT to SITT significantly improved COPD symptom management, pulmonary function, exacerbation rate, and treatment satisfaction in Korean cohort. Using a single inhaler to simplify therapy might increase patient compliance and improve clinical outcomes of COPD management.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1039-1050"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk and Protective Factors of COPD Among Smokers: A Cross-Sectional Study Using NHANES Database.","authors":"Xuequn Guo, Qiu Luo, Dongdong Chen, Hongsheng Lin","doi":"10.2147/COPD.S489581","DOIUrl":"https://doi.org/10.2147/COPD.S489581","url":null,"abstract":"<p><strong>Purpose: </strong>Smoking plays a significant role in the pathogenesis of chronic obstructive pulmonary disease (COPD), underscoring the importance of smoking cessation. Nevertheless, not all smokers who do not quit will necessarily develop COPD. This study aimed to examine the risk and protective factors associated with COPD among individuals who smoke.</p><p><strong>Patients and methods: </strong>The study included a cohort of 2619 adult smokers with lung function data, whose demographic characteristics, health status, lifestyle behaviors, and dietary patterns were examined using T-tests, Chi-square tests, and logical analysis.</p><p><strong>Results: </strong>Among the study participants, 441 individuals were identified as having COPD by analyzing pulmonary function data. Advanced age (p<0.001), low body mass index (BMI, p<0.001), ethnicity (p=0.019), and comorbid asthma (p<0.001) were found to be statistically correlated with the presence of COPD. Additionally, a higher intake of fruits and vegetables (p=0.026) was shown to have a beneficial impact. After considering factors related to type 2 inflammation, nutrient intake from vegetables and fruits, and other variables, it was observed that vitamin C (p<0.001) exhibited a protective effect against COPD in smokers. Additionally, advanced age (p<0.001), low BMI (p<0.001), comorbid asthma (p<0.001), and higher consumption of fruits and vegetables (p=0.032) remained significant independent risk factors for COPD in smokers. Furthermore, subgroup analysis revealed that COPD patients who consumed fewer fruits and vegetables had lower levels of vitamin C intake (p=0.004).</p><p><strong>Conclusion: </strong>The findings of our study suggest that smokers who are older, have a lower BMI, and comorbid asthma are at an increased risk of developing COPD. Conversely, higher consumption of fruits and vegetables, as well as increased intake of vitamin C, may help reduce this risk. Additionally, our results indicate that among smokers with lower fruit and vegetable intake, COPD patients tend to have lower levels of vitamin C consumption.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1027-1038"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Patients Receiving Budesonide/Glycopyrronium/Formoterol for Chronic Obstructive Pulmonary Disease in Spain: The AURA Study.","authors":"Myriam Calle Rubio, Juan Antonio Trigueros Carrero, Paula Chaparro Briones, Luciano Escudero Herrera, Michael Pollack, Ignacio Hernández Subirá, Joaquín Sánchez-Covisa","doi":"10.2147/COPD.S490227","DOIUrl":"https://doi.org/10.2147/COPD.S490227","url":null,"abstract":"<p><strong>Background: </strong>Single-inhaler triple therapy with budesonide/glycopyrronium/formoterol fumarate (BGF; Trixeo Aerosphere^®) was approved in the European Union in December 2020 for maintenance treatment in adult patients with moderate to severe chronic obstructive pulmonary disease (COPD) who are not adequately treated by dual therapy, and has been available in Spain since February 2022. This real-world, observational, retrospective cohort study, AURA Spain, describes the demographics, clinical characteristics, and healthcare resource utilization of patients initiating single-inhaler BGF triple therapy.</p><p><strong>Methods: </strong>Electronic medical records in the Spanish Healthcare System anonymized, integrated BIG-PAC^® database were analyzed to identify COPD patients aged ≥40 years initiating single-inhaler BGF between 1 February 2022 and 31 January 2023.</p><p><strong>Results: </strong>Patients (N=482) had a mean (standard deviation, SD) age of 71.5 (10.0) years, mean BMI of 29.6 (6.2) kg/m², most were aged ≥65 years (73.7%) and male (62.5%). Most were former (62.7%) or current (24.5%) smokers. Applying GOLD FEV₁ thresholds, severity of COPD was moderate in 49.8% of patients, severe (41.9%), and very severe (6.5%). The most common comorbidities were hypertension (62.2%), dyslipidemia (56.8%), and anxiety (42.5%), and 85.9% had one or more cardiovascular-related comorbidity. Overall, 57.3% experienced at least one moderate or severe exacerbation in the 12-month baseline period, 9.5% visited the emergency department for COPD-related reasons; and 12.7% were hospitalized for COPD (median length of stay 7 [interquartile range: 6-8] days). Patients initiating single-inhaled BGF triple therapy escalated from monotherapy (2.3%) or dual therapy (62.7%), switched from other triple therapies (31.3%), or were treatment-naïve (3.7%).</p><p><strong>Conclusion: </strong>Single-inhaler BGF triple therapy was initiated mostly as an escalation from dual maintenance therapy, with many switching from triple therapy, in patients with a high burden of disease, as demonstrated by their frequent exacerbation profile, advanced COPD severity (moderate to very severe obstruction) and the high frequency of several comorbidities, including cardiovascular diseases.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"999-1008"},"PeriodicalIF":2.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of Psychosocial and Sociodemographic Factors Associated with Low Medication Awareness in COPD Subjects: A Cross-Sectional Study, Findings from the Indonesian Family Life Survey 5.","authors":"Wardatul Jannah, Sofa D Alfian, Rizky Abdulah","doi":"10.2147/COPD.S498302","DOIUrl":"https://doi.org/10.2147/COPD.S498302","url":null,"abstract":"<p><strong>Purpose: </strong>To identify psychosocial and sociodemographic factors influencing low medication awareness among patients with Chronic obstructive pulmonary disease (COPD) based on Indonesian Family Life Survey 5 (IFLS-5).</p><p><strong>Methods: </strong>This study used a cross-sectional design, with data from IFLS-5 (2014/2015). Inclusion criteria were subjects with a self-reported diagnosis of COPD and aged at least 15 years. Two main factors were identified as modifiable psychosocial factors (eg, insomnia, depressive symptoms, happiness status, general health check status, smoking status, and health service satisfaction) and as non-modifiable sociodemographic factors (eg, gender, age, education level, marital status, economic status, insurance ownership, religiosity, comorbidity, and place of residence). Multivariate logistic regression analysis was used to explore the relationship between these factors and the awareness of COPD medication, by observing the adjusted odds ratio (aOR) within a 95% Confidence Interval.</p><p><strong>Results: </strong>There were 618 subjects identified with COPD, of which 53.40% were male. 84.30% of subjects have low medication awareness. Non-modifiable sociodemographic factors such as age 15-25 years (aOR: 2.531; 95% CI 1.024-6.253; p-value 0.044), age 26-35 years (aOR: 3.418; 95% CI 1.444-8.091; p-value 0.005), high school education level (aOR: 4.870; 95% CI 1.685-14.078; p-value 0.003), and modifiable psychosocial factors such as satisfaction with health services with the category \"sufficient\" (aOR: 2.510; 95% CI 510; 95% CI 1.508-4.176; p-value 0.000), and subjects who smoked (aOR: 1.894; 95% CI 1.147-3.127; p-value 0.013), were significantly associated with low COPD medication awareness.</p><p><strong>Conclusion: </strong>This study shows that most subjects with COPD had low medication awareness, which is influenced by factors such as age, education level, smoking habits, and satisfaction with health services. This highlights the need for targeted interventions for high-risk groups. Limitations of this study include reliance on self-reported data, which may lead to recall bias. In addition, this study was unable to provide evidence of a causal relationship.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"1009-1026"},"PeriodicalIF":2.7,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11994071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal Brain Functional Connectivity in Patients with Chronic Obstructive Pulmonary Disease and Correlations with Clinical and Cognitive Parameters.","authors":"Kyung-Il Han, Yoomi Yeo, Hang Joon Jo, Min Ju Jo, Yeonkyung Park, Tai Sun Park, Sung Jun Jung, Jin Ho Bae, Sung-Ho Jang, Joonho Choi, Dong Woo Park, Tae-Hyung Kim","doi":"10.2147/COPD.S505271","DOIUrl":"https://doi.org/10.2147/COPD.S505271","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is a major comorbidity of chronic obstructive pulmonary disease (COPD), but the underlying mechanisms are not fully understood. In this study, we used resting-state functional magnetic resonance imaging to investigate brain functional connectivity (FC) abnormalities in patients with COPD and explored the correlation between abnormal FC and COPD-related clinical parameters.</p><p><strong>Methods: </strong>Forty-one patients with COPD, without a definite diagnosis of cognitive impairment or depression, and 30 age- and sex-matched controls were recruited. A total of 184 resting-state functional connectivity (RSFC) maps were generated for all seed points. Welch's <i>t</i>-test was used to assess differences in RSFC between the COPD and control groups, and the correlation coefficients between RSFC and clinical parameters were calculated.</p><p><strong>Results: </strong>Patients with COPD had lower scores on the Mini-Mental State Exam (MMSE) and Korean version of the Montreal Cognitive Assessment and higher scores on the Beck Depression Inventory than the control group. Additionally, patients with COPD showed decreased RSFC in the left middle-posterior cingulate cortex, left posterior-dorsal cingulate cortex, and right superior occipital gyrus and increased RSFC in the left superior temporal sulcus, left posterior transverse collateral sulcus, right occipital pole, and right precentral gyrus. The regions showing differences in FC correlated with MMSE score, COPD symptom assessment scales, such as the COPD Assessment Test and modified Medical Research Council Dyspnea Scale, and pulmonary function parameters, including forced expiratory volume in one second and forced vital capacity.</p><p><strong>Conclusion: </strong>Patients with COPD showed significant differences in FC within specific brain regions that correlated with symptoms, cognition, and lung function.</p>","PeriodicalId":48818,"journal":{"name":"International Journal of Chronic Obstructive Pulmonary Disease","volume":"20 ","pages":"971-985"},"PeriodicalIF":2.7,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}